Forms


Below is a list of AGED’s most common trust forms. While we prefer that you come in the office to discuss your trust needs, some people like to prepare their own documents, or fully review the forms before their meeting.

Click the link to below to jump to the particular forms you are interested in.

These documents are available in PDF format, making it easy to download and print. If you do not have a PDF reader on your computer, you may download one here: Free Adobe Reader.

Instructions

Documentation Needed to Establish a Trust with AGED

Documents Needed for Medicaid Applications

Making Deposits Into a Client’s Special Needs Trust Account New Deposit Instructions effective 07/01/2017 *Please call the office to obtain deposit instructions*

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The Florida Public Guardianship Pooled Special Needs Trust

AGED has been named the Administrative Trustee for the Florida Public Guardianship Pooled Special Needs Trust. Click here to access the documents for this trust.

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AGED d(4)(C) Pooled Trust Documents

Documentation Needed to Establish an AGED Trust

AGED Welcome Letter

AGED d(4)(C) Pooled Master Trust Agreement

AGED d(4)(C) Pooled Fee Agreement (Fillable)

AGED d(4)(C) Joinder Agreement (Fillable)

Instructions for Completing Pooled SNT Joinder Agreement

Disbursement Request Form (Fillable)

Authorization to Disclose Information to a Third Party Individual or Firm (Fillable)

Sample Petition and Order Authorizing Guardians to Establish a Pooled Trust

Authorization for Direct Transfer VIA ACH

Online Access Form

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AGED Third Party Trust Documents

Documentation Needed to Establish an AGED Trust

AGED Welcome Letter

AGED Signed Third Party Master Trust Agreement

AGED Third Party Fee Agreement (Fillable)

AGED Third Party Joinder Agreement (Fillable)

Disbursement Request Form (Fillable)

Authorization to Disclose Information to a Third Party Individual or Firm (Fillable)

Authorization for Direct Transfer VIA ACH

Online Access Form

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AGED Group Home and Discounted Nursing Home Medicaid Account Documents

Important Note: AGED’s Discounted Fee Agreement for Nursing Home Medicaid is for individuals in a Nursing Home placing income only and/or less than $5,000 in assets into the trust. If assets are above $5,000 please use AGED’s d(4)(C) Pooled Trust Documents.

Documentation Needed to Establish an AGED Trust

AGED Welcome Letter

AGED Master Trust

AGED Group Home Fee Agreement (Fillable)

AGED Discounted Fee Agreement for Nursing Home Medicaid (Fillable)

AGED Discounted Nursing Home Medicaid / Group Home Joinder Agreement (Fillable)

Disbursement Request Form (Fillable)

Authorization to Disclose Information to a Third Party Individual or Firm (Fillable)

Authorization for Direct Transfer VIA ACH

Online Access Form

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AGED Guardianship Benevolent Fund Documents

Guardianship Benevolent Fund Application (Fillable)

Guardianship Benevolent Fund Instructions

Guardianship Benevolent Fund Disbursement Request Form (Fillable)

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Do you need additional information not located on this page? Feel free to contact us anytime with any questions you may have.

AGED’s Online System

FL Public Guardianship Trust

AGED is the Administrative Trustee for The Florida Public Guardianship Pooled Special Needs Trust.

Click here for forms and additional information about this trust


Contact AGED

Phone: (407) 682-4111
Toll Free: (888) 277-1826

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